摘要
目的探讨脐带血清降钙素原(PCT)对新生儿宫内感染早期诊断的价值。方法选取2016年1月-2017年1月于医院分娩的新生儿586例为研究对象,根据是否具有感染高危因素及感染结局分为三组,对照组:无宫内高危感染因素且无感染173例;试验组A:有宫内高危感染因素但无感染203例;试验组B:有宫内高危感染因素且有感染210例。检查产妇在孕产期内的医疗记录,出生时脐动脉穿刺获得脐带血样本,检测样本的PCT、C-反应蛋白(CRP)水平及静脉血白细胞计数(WBC)。结果三组新生儿性别、孕周差异无统计学意义;试验组B的新生儿体质量为(3 444.56±493.34)g低于试验组A(3 590.67±508.05)g和对照组(3 627.46±489.61)g(P<0.05);试验组B新生儿PCT和CRP分别为1.22(0.68,62.32)ng/ml、0.64(0.43,56.00)mg/L高于试验组A 0.71(0.52,12.13)ng/ml、0.33(0.22,2.32)mg/L和对照组(P<0.05);PCT对新生儿宫内感染的预测的最佳临界值为2ng/ml,当PCT>2ng/ml时,新生儿患宫内感染阳性预测值为34.36%,当PCT<2ng/ml时,不出现患新生儿宫内感染阴性预测值为91.35%。结论脐带血清PCT可作为宫内感染早期诊断的有效性指标,且在PCT值为2ng/ml时具有最佳的预测效果。
OBJECTIVE To explore the value of umbilical cord serum procalcitonin(PCT)in early diagnosis of neonatal intrauterine infection.METHODS 586 newborns who were born in our hospital from Jan.2016 to Jan.2017 were divided into three groups according to the risk factors of infection and the outcome of infection.Control group:173 newborns who had no intrauterine high-risk infection factors and no infection;experimental group A:203 newborns who had intrauterine high-risk infection factors but no infection;experimental group B:210 newborns who had intrauterine high-risk infection factors and infection.The maternal medical records during pregnancy were examined,and cord blood samples were obtained through umbilical arterial puncture at time of birth and tested for PCT,C-reactive protein(CRP)levels and venous blood white blood cell(WBC)counts.RESULTS There were no significant differences in the gender and gestational age among the three groups of newborns.The body weight of the newborns in the experimental group B was(3 444.56±493.34)g,significantly lower than that in the test group A(3 590.67±508.05)g and the control group(3 627.46±489.61)g(P<0.05).The PCT and CRP of neonatal group B were 1.22(0.68,62.32)ng/ml and 0.64(0.43,56.00)mg/L,respectively,significantly higher than those of test group A 0.71(0.52,12.13)ng/ml,0.33(0.23,2.32)mg/L and control group(P<0.05).The optimal cut-off value for PCT for neonatal intrauterine infection was 2 ng/ml.When PCT was>2 ng/ml,the positive predictive value of neonatal intrauterine infection was 34.36%,when PCT was<2 ng/ml,the negative predictive value of no intrauterine infection in neonates was 91.35%.CONCLUSIONUmbilical cord Serum PCT can be used as an effective indicator for early diagnosis of intrauterine infection,and the best predictive effect is obtained at a PCT level of 2 ng/ml.
引文
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